MAC Intraoperative Complications & Emergency Management

Question 1

What is the definitive airway management strategy when 'cannot intubate, cannot oxygenate' (CICO) is declared?

Accepted Answer

Emergency surgical airway (cricothyrotomy)

Answer

In a CICO emergency, an emergency cricothyrotomy provides the definitive pathway to oxygenation when all conventional airway methods have failed.

Question 2

What are the hallmark early signs of anaphylaxis occurring under general anesthesia?

Accepted Answer

Bronchospasm, hypotension, and urticaria

Answer

Anaphylaxis under anesthesia typically presents with bronchospasm, cardiovascular collapse, and skin manifestations like urticaria or flushing.

Question 3

What is the first-line drug for treating anaphylaxis under anesthesia?

Accepted Answer

Epinephrine IV or IM

Answer

Epinephrine is the first-line treatment for anaphylaxis, addressing bronchoconstriction, vasodilation, and mast cell mediator release simultaneously.

Question 4

Which intraoperative event is characterized by a sudden decrease in end-tidal CO2?

Accepted Answer

Venous air embolism

Answer

Venous air embolism causes a sudden drop in EtCO2 due to dead space ventilation as air obstructs pulmonary circulation.

Question 5

What is the primary treatment for a massive pulmonary embolism occurring intraoperatively?

Accepted Answer

Systemic anticoagulation and hemodynamic support

Answer

Massive PE requires immediate systemic anticoagulation (or thrombolysis if warranted) and hemodynamic support to maintain cardiac output.

MAC - Maintaining Anesthesia Certification Practice Test